What happened? ‘I am not sure.’

Some of the other veterinarians on this blog have eluded to the most common questions asked an emergency veterinarian. I would like to give you one of the most common answers that emergency veterinarians get when they ask, “What happened?” Most say “I don’t know.” (I must admit that when the patient is not critical, I think to myself, “How am I going to figure out what happened? I was not there.” I then remember, smiling, I think I went to school for this.) This leads to a series of questions in which I hope to build some understanding of the events that led this pet to our clinic.

For example, one night a 2-year-old black female Great Dane comes into the emergency clinic. The owner stated she was out chasing one of her other dogs. When she came home she found her front door open and her Great Dane in her kennel hiding/scared. As the owner looked her over she discovered a cut on her head and one on her left ear. The owner is unsure what happened to her in those 20 minutes while she was gone (she was fine/non-injured before she left). During my examination, I noticed that she had some abrasions along her inner thighs and she seemed to be taking deep breaths. She seemed fine otherwise. In listening to her lungs, they did not sound as if she had any problems/pathology. I suspected, given the history, that this Great Dane had been hit by a car. In making my recommendations to the owner, I always find it difficult to explain doing certain diagnostics, such as x-rays on the chest and bloodwork, when the patient does not seem all that bad. This owner allowed me to do the bloodwork and x-rays.

You can see the x-rays of the chest on the picture above. This patient had a pneumothorax with some lung contusions. A pneumothorax is simply air outside the lung and within the chest cavity. The medical definition of a pneumothorax is a potential medical emergency wherein air or gas is present in the pleural cavity. The pneumothorax is noted in the x-ray by the heart elevating some off the sternum (ventral chest). Since the Great Dane was stable and oxygenating well, we decided to observe. We will discuss thoracic trauma a little more next week. She stayed on intravenous fluids and was monitored closely. Within 24 hours, her x-rays looked like this:

You can see that the heart has lowered closer to the sternum (ventral chest). She was able to go home within 48 hours and did very well at home.